游离股前外穿支皮瓣在原发体表恶性肿瘤术后创面修复中的应用

Reconstruction of Soft Tissue Defect After Primary Superficial Malignant Tumor Excision with Free Anterolateral Thigh Perforator Flap

[目的]探讨游离股前外穿支皮瓣在原发体表恶性肿瘤术后创面修复中的应用价值。[方法]2015~2017年完成游离股前外穿支皮瓣原发体表恶性肿瘤术后复杂创面修复15例,其中足底皮肤黑色素瘤5例,皮肤鳞癌3例,复发软组织肉瘤7例。皮肤缺损面积5cm×6cm^20cm×30cm。[结果 ]肿瘤达R0根治,皮瓣均成活。3例术后血管危象,二次探查后成活。随访3~33月,未见肿瘤复发。供区愈合良好,无下肢活动障碍。[结论]游离股前外穿支皮瓣应用于体表恶性肿瘤术后创面缺损修复安全有效,值得进一步推广。

[Objective]To explore the clinical effect of the free anterolateal thigh perforator flap used for the reconstruction of soft tissue defect after primary superficial malignant tumor excision.[Method]A total of 15 patients with primary superficial malignant tumor underwent wide resection and reconstructed with free anterolateal thigh perforator flap,including melanoma on heel and sole（5 cases）,skin squamous cell cancinoma（3 cases）,recurrent soft tissue sarcoma（7 cases）.The flap sizes varied from 5 cm×6 cm to 20 cm×30 cm.[Results]All of the patients were R0 resected and the flaps survived successfully.Three patients got emergent surgical exploration for vascular crisis.All the patients were followed for three to thirty-three months,and no tumor recurrent was found during the following time.The donor sites were well healed and no movement disorder were observed.[Conclusion]Free anterolateal thigh perforator flap is a good choice used for the reconstruction of soft tissue defect after primary superficial malignant tumorexcision.